Syria

The impact of explosive weapons on children in Syria

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By William Grant-Brook and Verity Hubbard

A generation of Syrians has been born into war. As the Syrian conflict closes in on a decade, at least 3 million Syrian children under the age of six know nothing but conflict. Children continue to suffer horrendously, facing trauma that will impact them for years to come.

Explosive weapons have been at the forefront of children's suffering there. Aerial attacks and the use of barrel bombs by government forces and indiscriminate shelling and improvised explosive device attacks by armed groups, were found by the UN to be the primary cause of death and injury among Syrian children. Countless children have been killed as a result of the use of cluster munitions, thermobaric bombs, improvised munitions such as barrel bombs, and other explosive weapons. These weapons have often been used against civilian targets including schools and hospitals.

The horrors are too multiple to list. Sieges of towns and villages, sometimes months long, were regularly accompanied by near-constant shelling and aerial bombardment. Alongside the direct killing of children, indirect impacts include forced displacement, health (including mental) challenges and the interruption of education.

Despite widespread perceptions that the conflict has been drawing to a close, it continues. In the North-West of Syria, the current epicentre of the violence, children are particularly vulnerable. 2018 was the worst year of the conflict for Syria's children according to UNICEF, with 1,106 killed in fighting. This is reflected in AOAV's data on the use of explosive weapons in Syria, which also shows 2018 to be the deadliest year thus far. This high level of casualties continued into 2019: the UN Secretary General reported 1,454 children victims, including 897 killings of children. The vast majority of these casualties were from explosive violence: 515 from air strikes; 332 from shelling; 301 from unexploded ordnance; and 165 casualties from attacks with improvised explosive devices.

These figures are likely to be vastly lower than the true number due to underreporting and the difficulties of assessing casualty statistics in Syria, where official accounts of the death tolls have ceased, and where the UN Human Rights Chief Michele Bachelet says, "it is no longer even possible to give a credible estimate [of victims]". Not only are fatalities difficult to estimate, but AOAV's own research shows that injuries were consistently going unrecorded, particularly as the conflict in Syria continued. Many of the casualties will be children, who will likely be severely impacted by their injuries and require specialist care for the rest of their lives.

Impact on Children

Displacement\ More than any other form of violence in Syria, the use of explosive weapons has destroyed homes, communities and infrastructure, leading to 6.7 million people being internally displaced. Of those displaced inside Syria, an estimated 2.6 million are children, and approximately 2.5 million girls and boys are living as refugees. These families have been forced into new realities in communities of refugees and internally displaced persons (IDPs) where children are particularly at risk. For example, an International Crisis Group report on refugees in Turkey showed that young Syrian boys were targets of criminal and militant networks, while young Syrian girls were at risk of exploitative marriages needed to ensure their families financial stability as well as sex work. In both Turkey and Lebanon interviews carried out by AOAV found that many Syrian refugee children were carrying out labour to help support their families.

The Syrian government advance on the northwest from late 2019 to February 2020 led to the displacement of close to 500,000 children. The short-term effects are stark. Mark Lowcock, the UN's coordinator for humanitarian efforts, noted children and babies, "[died] because of the cold," following "indiscriminate" violence. In one week in early February 2020 alone, dozens of children perished due to the terrible conditions within the displacement camps in Syria's Idlib. The harsh conditions of displacement camps have also driven displaced persons to return to their neighbourhoods as soon as possible, opening them up to the dangers of explosive remnants of wars.

The sheer number of explosive weapons used has led to a mass of unexploded bombs and shelling, as well as landmines, that pose a risk of detonation years after they were used or discarded. According to the United Nations Mine Action Service (UNMAS), children in Syria are particularly vulnerable as they are widely unaware of the dangers of picking up items from the ground. Additionally, children form a large proportion of the population of Internally Displaced Persons (IDP's) in Syria who may enter areas without knowing the local risks; around a quarter of the 12,000 victims of explosive hazards accidents have been children, with 61% injured or killed when playing in residential areas. This is especially true in areas that have seen some of the most intense fighting such as Aleppo, Dara'a, Idlib and Raqqa.

Education\ In addition to its direct physical impact, explosive violence has denied Syria's children access to the public institutions most crucial to their safety and development by destroying buildings such as education and health facilities. This impact has proliferated in recent years. In 2019, there were a total of 262 attacks on schools (157) and hospitals (105), including on protected personnel. The majority of those attacks (192) occurred in Idlib, involving air strikes (158), shelling (50), explosions of unknown nature (34) and attacks using IEDs (6). UN Secretary General Guterres has said he is, "particularly disturbed by the increase in the number of attacks against schools and hospitals".

During the conflict, 40% of Syria's schools (over 7,000) have been damaged or destroyed. Various evidence throughout the war has suggested the deliberate targeting of schools by government forces, while mortar attacks by anti-government forces have killed children at schools in government held areas, especially in the early days of the civil war. Those schools that are still functioning often lack basics such as doors, windows and water tanks, which were destroyed during fighting.

Informal structures of education have also been attacked. Following years of schools being targeted, in some rebel-held areas such as the Eastern Ghouta suburb of Damascus, formal education facilities were closed for fears of being targeted by government and Russian warplanes. Informal schools opened in basements to offer greater protection. These schools were frequently attacked, killing the children and teachers within. Schools are also a particular target during sieges; during the siege of Aleppo 73% of schools suffered damage.

To date, more than 2.1 million girls and boys within Syria have ceased to attend school on a regular basis. That number rises to almost 3 million when you factor in Syrian refugee children in neighbouring countries deprived of an education. A further 1.3 million children are at risk of dropping out or not learning. When children do attend formal education, issues of overcrowding are significant; the UN Commission of Inquiry on Syria has received reports that some classes comprise 120 children. In displacements camps, access to education remains insufficient, such as the Al Hol camp in North East Syria where tens of thousands of children are out of school.

The impacts of a lack of schooling leave a stark future for children's development. Reports of illiteracy are widespread. An International Rescue Committee study in 2017 found almost three-quarters of children in the review had reading and maths levels three or more years behind where they should be. The destruction of education facilities has other long term effects, including children not learning about hygiene practices typically taught in school.

Between November 2019 and June 2020, 58 educational facilities in Idlib and neighbouring western Aleppo, where just less than half of the population are under the age of 15, were damaged; most due to the use of explosive weapons by pro-government forces.

*Psychological and Physical Health *\ The use of explosive weaponry on health infrastructure is well documented. Physicians for Human Rights corroborated 595 attacks on at least 350 separate facilities and documented the killing of 923 medical personnel from March 2011 through February 2020, including 83 occasions of the use of indiscriminate barrel bombs on medical facilities. As part of government campaigns to regain control of rebel-held areas, certain strikes have targeted or hit health facilities designed for children, including the bombing on May 15th 2019 of the Tarmala Maternity and Children's Hospital in Idlib and the destruction of a hospital sponsored by Médecins Sans Frontières specialising in paediatric health in Idlib on August 6th 2016, which killed five children.

This destruction of healthcare infrastructure occurs alongside an increased need for attention to the direct and indirect impacts of explosive weapons on the health of children. A study in 2015 of over 1,000 children in North West Syria found that 64% of the children examined suffered from infections, mostly of respiratory, neurological and digestive origin. Poor living conditions and the lack of paediatric healthcare puts Syrian children at serious risk. The attacks on healthcare have also left Syrians further disadvantaged amid the global struggle against COVID-19, for which Syria is wholly unprepared.

Explosive weapons have also had a profound impact on the mental health of children. In a study by Save the Children on children's mental health in the Syrian conflict, ongoing bombing and shelling was said to be the number one stress in the lives of children, with 89% of respondents saying children's behaviour had become more fearful and nervous, including increased receptiveness to loud noises. Over 70% also showed signs of toxic stress and post-traumatic stress disorder as well as more aggressive behaviours. As a result of repeated exposure to explosive violence, children exhibit signs of trauma, including psychological and behavioural disorders, as well as chronic fatigue and acute stress.

Malnutrition is a further health risk for children, exacerbated by attacks on food infrastructure, something that has continued in recent years, in part as a result of bombing of markets. The UN estimates that 4.7 million children in Syria require humanitarian assistance and that more than 3.1 million children under five require nutritional support.

**Conclusion **\ Evidently, the impact of explosive violence on children in Syria has been severe and is likely to have a lasting impact on long-term development and health. From widespread displacement to the destruction of health and education facilities and the sheer numbers killed and injured by explosive weapons, the risks to children are particularly acute. This impact on children is likely to be felt for generations.